Inhibitor of differentiation 4 (ID4), a member of the helix-loop-helix family of transcriptional regulators has emerged as a tumor suppressor in prostate cancer (PCa). Recent studies have shown that Id4 is highly expressed in the normal prostate and decreases in prostate cancer due to epigenetic silencing. Id4 knockdown in androgen sensitive LNCaP cells has been shown to lead to castration resistant prostate cancer (CRPC) in vitro and in vivo. Id4-/- mice leads to underdeveloped prostate with PIN like lesions without the loss of Androgen Receptor (AR) expression. In this study we demonstrate that the loss of ID4 expression in PCa cell line LNCaP and DU145 may promote tumorigenesis by promoting stemness. LNCaP cells with stably silenced ID4 ((-)ID4) using retroviral based shRNA and LNCaP transfected with non-specific shRNA were used to perform colony forming assay and prostatosphere formation using matrigel. Expression of cancer stem cell markers was determined using western blotting and immunocytochemistry (ICC). FACS analysis was used to sort stem cells and determine the ID4 expression. Xenograft study was performed on SCID mice using CD133 positive LNCaP cells. LNCaP(-)ID4 and DU145 cells lacking ID4 showed increased holoclone as well as decreased paraclone formation, which are believed to be derived from stem cells and differentiated cells respectively, as compared to non-silencing control in the colony forming assay. There was also an increase in prostatosphere development in the LNCaP (-) ID4 cells indicating that the loss of ID4 is responsible for promoting the LNCaP cells towards cancer stem cells. The results were further validated via western blotting and ICC using known cancer stem cell markers on the holoclones and paraclones formed by these cells. Xenograft study showed that 10,000 cells from CD133 positive LNCaP cells developed tumor on SCID mice. This study reports for the first time that loss of ID4 increases holoclone and prostatosphere formation indicating that Id4 may contribute to promoting stemness in prostate cancer cells.

O alívio da dor humana é preceito defendido há milênios e considerado importante missão dos profissionais da saúde. No entanto, milhões de pacientes todos os anos sofrem de dor aguda como resultado de um trauma, doença ou cirurgia. A dor aguda em pós-operatório, decorrente de lesões teciduais, pode gerar alterações fisiológicas que, se não forem resolvidas podem resultar em dor crônica, trazendo prejuízos à saúde e à qualidade de vida. A cirurgia de mastectomia, principal abordagem terapêutica para o tratamento primário do câncer de mama, é responsável por uma série de alterações vivenciadas pelos pacientes que a enfrentam, pois é um processo cirúrgico agressivo que pode levar à ocorrência de dor persistente no pós- operatório. O presente estudo consiste de uma revisão integrativa de literatura com o objetivo de analisar as evidências disponíveis na literatura sobre o manejo da dor pós-operatória em pacientes submetidos à mastectomia. A busca dos estudos primários foi realizada nas bases de dados LILACS, PubMed e CINAHL e compreendeu o período de julho de 2007 a julho de 2012. A amostra constituiu de 21 artigos científicos, que foram reunidos em quatro categorias temáticas: intervenções farmacológicas (5 artigos), intervenções não farmacológicas (4 artigos), técnicas anestésicas (11 artigos) e mensuração da dor (1 artigo). Os resultados evidenciaram que nos estudos com intervenções farmacológicas para o controle da dor pós- operatória, os fármacos utilizados como adjuvantes, associados aos analgésicos, AINEs, anestésicos e opioides, foram os anticonvulsivantes, os corticosteroides e os antidepressivos, que demonstraram ser adjuvantes seguros e eficazes para o manejo da dor após a mastectomia; algumas intervenções não farmacológicas, como medidas educacionais, musicoterapia e hipnose para analgesia pós-operatória foram investigadas com resultados positivos, mas esses achados necessitam de confirmação com estudos maiores e controlados para comprovar os benefícios dessas terapias sobre o manejo da dor em pacientes submetidos à mastectomia; apesar de mais pesquisas serem necessárias para avaliar o impacto do tratamento da dor pós-operatória sobre a síndrome da dor crônica pós-mastectomia, estudos demonstraram que o manejo adequado e eficaz da dor pós-operatória pode evitar o desenvolvimento dessas síndromes; as técnicas anestésicas foram a estratégia mais frequentemente utilizada para o manejo da dor pós-mastectomia e demonstraram ser eficazes na diminuição da dor aguda e na redução da necessidade de opioide intra e pós-operatório; há poucos estudos científicos que abordam a assistência de enfermagem no manejo da dor pós- mastectomia, evidenciando a necessidade de um número maior de publicações sobre o tema, por enfermeiros. Que estes resultados sirvam como estímulo para o desenvolvimento de novas pesquisas, no intuito de contribuir para o manejo eficaz e efetivo da dor pós-operatória em pacientes submetidos à mastectomia / Human pain relief is precept defended for millennia and considered important mission of heath care provider. However, millions of patients each year suffer acute pain as a result of trauma, disease or surgery. Acute pain in the postoperative period, resulting in tissue lesions, can cause physiological changes that, if not solved can result in chronic pain, impairing the health and quality of life. The mastectomy surgery, the main therapeutic approach for the treatment of primary breast cancer, is responsible for several changes experienced by patients because it is an aggressive surgical process that may result persistent pain in postoperative period. This study is an integrative literature review that aimed to analyze the evidence available in the literature on the postoperative pain management in patients undergoing mastectomy. The search of the primary studies was performed in the databases LILACS, PubMed and CINAHL and included the period between from July 2007 to July 2012. The sample consisted of 21 papers, which were grouped in four thematic categories: pharmacological interventions (5 studies), non-pharmacological interventions (four studies), anesthetic techniques (11 studies) and pain measurement (1 study). The results showed that in studies of pharmacological interventions for the postoperative pain control, the drugs used as adjuvants, associated with analgesics, nonsteroidal anti-inflammatory drugs, anesthetics and opioids were anticonvulsants, corticosteroids and antidepressants, which have proven to be safe and effective adjuvants for pain management after mastectomy; some non- pharmacological interventions for postoperative analgesia were investigated and the results were positive, but these findings need to be confirmed by larger and controlled studies to prove the benefits of these therapies for pain management in patients undergoing mastectomy, although more research is needed to assess the impact of treatment of postoperative pain on the syndrome of chronic post-mastectomy pain, studies have shown that proper and effective postoperative pain management may avoid the development of these syndromes; anesthetic techniques were the most frequently used strategy for the pain management after mastectomy and shown to be effective in decreasing acute pain and reduced need for opioid intra and postoperative; there are few scientific studies on nursing care in the management of pain after mastectomy, evident the need for a greater number of works on the theme, by nurses. It is expected that the results encourage the development of new research that may contribute to the efficient and effective management of postoperative pain in patients undergoing mastectomy

Submitted by Angela Maria de Oliveira (amolivei@uepg.br) on 2017-08-16T18:53:41Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Lima, Cinthia.pdf: 1054815 bytes, checksum: 5c7babe47287ad0cea477f3943ddbe49 (MD5) / Made available in DSpace on 2017-08-16T18:53:42Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Lima, Cinthia.pdf: 1054815 bytes, checksum: 5c7babe47287ad0cea477f3943ddbe49 (MD5) Previous issue date: 2017-02-20 / Os temas saúde, doença e formas de cura se constituem em objetos de interesse na historiografia atual, muito mais que apenas observações sobre como uma determinada população ou comunidade local. A abertura para tópicos que abordam temas ligados à saúde possibilitou o entendimento do poder e a força dos conhecimentos tradicionais e da cultura de uma comunidade no trato das mais diversas formas de doença. A OMS (Organização Mundial de Saúde) desde 1980 preconiza em todo o mundo a iimplementação de formas de medicina integrativa (acupuntura, homeopatia e fitoterapia) como forma de humanização no tratamento público, através do respeito das raízes culturais das distintas sociedades. Esta pesquisa teve como objeto geral a avaliação e o impacto de um projeto de medicina integrativa em que a fitoterapia foi disponibilizada na saúde pública através dos SUS (Sistema Único de Saúde) à população do município de Telêmaco Borba- PR no período de 1993 a 2008 através da Fabrimed (Fabricadora Municipal de Medicamentos), já extinta há quase uma década. A pesquisa concentra-se na análise histórica do funcionamento do projeto, a importância das agrovilas na estruturação e no funcionamento, desde a implantação, assim como se descreve a importância para a comunidade e a constituição de sua identidade. Faz-se uma análise qualitativa e quantitativa dos prontuários médicos do período de funcionamento do projeto e se observam as vivências percepções e significados que muitas vezes no contexto geral ficam silenciados, mas que acabam demonstrando a capacidade da medicina integrativa em intervir no sistema de saúde pública. / The themes health, disease and forms of healing are objects of interest in the current historiography, much more than just observations on how a particular population or community react in the search for the most diverse forms of healing intimately linked to the identity of a society. The opening to the topics that address health issues has made it possible to understand the power and strength of traditional knowledge and the culture of a community in dealing with the most diverse forms of disease. The World Health Organization (WHO) since 1980 advocates worldwide implementation of forms of integrative medicine (acupuncture, homeopathy and phytotherapy) as a way of humanizing public treatment by respecting the cultural roots of different societies. This research had as general object the evaluation and the impact of an integrative medicine project in which the phytotherapy was made available in the public health through the Unified Health System (SUS in Portuguese) to the population of the city of Telêmaco Borba-PR during the period of 1993 to 2008 through Fabrimed (Municipal Drug Manufacturers), already extinct almost a decade ago. The research focuses on the historical analysis of the operation of the project, the importance of rural villages in the structuring and operation, since the implantation, as well as the importance for the community and the constitution of its identity. It carries out a qualitative and quantitative analysis of the medical records of the project's period of operation and remarks perceptions and meanings that are often silenced in the general context, but which show the capacity of integrative medicine to intervene in the public health system.

A partir da hipótese de que pessoas leigas, ou seja, “não profissionais” de saúde, apresentam baixo conhecimento sobre medicamentos, o estudo teve por objetivo identificar por meio de uma revisão integrativa as variáveis que interferem no letramento em saúde relacionado ao uso de medicamentos por pacientes atendidos em serviços de saúde. Trata-se de uma revisão integrativa que por definição sintetiza resultados obtidos em pesquisas oferecendo informações amplas sobre um tema, e pode ter diferentes finalidades, como definir conceitos, revisar teorias ou analisar métodos de estudos, permite a inclusão simultânea de pesquisa quase-experimental e experimental e combinando dados de literatura teórica e empírica. Realizada no período de janeiro a abril de 2016, foram utilizadas as bases de dados MEDLINE/PubMed, LILACS, SciELO, Google Acadêmico e BDTD. O levantamento abrangeu publicações nacionais e internacionais, em português, inglês ou espanhol, no intervalo de janeiro/1996-janeiro/2016, usando as palavras chave “health literacy”, “health education”, “medication knowledge”, “patient medication knowledge”, “patient”, “medication”, “education” e “patient*participation”. Os critérios de inclusão foram: idade >18 anos, ambos os sexos, qualquer país ou nível socioeconômico; usar técnicas de medir letramento e os de exclusão: estudos com grupos étnicos e camadas sociais pré-definidos; crianças ou seus cuidadores, gravidez, doenças específicas, etc. Foram identificados 637 estudos e excluídos 609 por diversos motivos, restando 28 na amostra final. Os países com maior número de estudos recuperados foram Estados Unidos, Brasil e Espanha, respectivamente, sendo a maior concentração a partir de 2009. Em relação ao delineamento científico dos estudos: 23 eram de natureza quantitativa, 3 qualitativos e 2 mista (quali-quantitativo). As principais questões sobre medicamentos estudadas foram: relação entre o nível educacional e o letramento funcional em saúde, a relação entre conhecimento de medicamentos, adesão à terapia e intervenções educativas. Sobre os métodos para identificar/avaliar o letramento em saúde o TOFHLA, a sua versão reduzida (S-TOFHLA) e REALM foram usados em dois estudos cada um deles. Em 17 estudos os questionários foram desenvolvidos pelos próprios pesquisadores e em três estudos foi também avaliada a adesão pelo Morisky-Green. A pesquisa de letramento em saúde pode auxiliar em programas sobre o uso racional de medicamento, pois parece existir uma correlação positiva entre letramento funcional em saúde e conhecimento sobre medicamentos, e este conhecimento está positivamente relacionado à adesão à terapia medicamentosa. / Based on the hypothesis that lay people, i.e. "non-professionals" of health, have low knowledge regarding medicines, this study aimed to identify, through an integrative review, the variables that affect the health literacy related to the use of medicines by patients treated in health services. This is an integrative review which summarizes results obtained in scientific researches offering comprehensive information on a topic and can have different purposes, such as defining concepts, revising theories or analyzing study methods, it allows the simultaneous inclusion of quasi-experimental research and experimental, combining data from the theoretical and empirical literature. The research was carried out from January to April 2016, during this period, the database from MEDLINE/PubMed, LILACS, SciELO, Google Academic and BDTD were used. The search included national and international publications, in Portuguese, English or Spanish, in the period from January 1996 to January 2016, using the keywords "health literacy", "health education", "medication knowledge", "patient medication knowledge", "Patient", "medication", "education "and" patient*participation". The inclusion criteria were: age>18 years old, both sexes, any country or socioeconomic level; to use literacy and exclusion techniques: studies with pre-defined ethnic groups and social strata; children or their caregivers, pregnancy, specific diseases, etc. 637 studies were identified and 609 were excluded for several reasons, leaving 28 in the final sample. The countries with the highest number of studies recovered were the United States, Brazil and Spain, respectively, with the highest concentration starting from 2009. Regarding the scientific design of the studies: 23 were quantitative, 3 qualitative and 2 mixed (qualitative-quantitative). The main questions related to the studied drugs were: the relationship between educational level and functional literacy in health, the relationship between knowledge of medicines, adherence to therapy and educational interventions. On methods to identify/evaluate health literacy in health, TOFHLA, its reduced version (S-TOFHLA) and REALM were used in two studies each of them. In 17 studies the questionnaires were developed by the researchers themselves and in three studies the adhesion by Morisky-Green was also evaluated. The health literacy research can assist programs on the rational use of medicines since there seems to be a positive correlation between functional literacy in health and knowledge about medicines, and this knowledge is positively related to adherence to drug therapy.

A Promoção da Saúde tem contribuído para a construção de ações que possibilitam responder aos interesses e demandas da população visando à melhoria do nível de sua saúde. Como forma de integrar outras racionalidades médicas à Atenção a Saúde, o Ministério da Saúde aprovou, em 2006, a Política Nacional de Práticas Integrativas e Complementares (PNPIC) buscando atender, sobretudo, a necessidade de incorporar e implementar experiências que há algum tempo vêm sendo desenvolvidas com sucesso no Sistema Único de Saúde (SUS) em resposta ao desejo de parte dos usuários, expresso nas recomendações de Conferências Nacionais de Saúde, desde 1988. Assim, tem se tornado cada vez mais urgente investigar os conhecimentos, opiniões e representações sociais dos gestores e profissionais de saúde sobre essas Práticas (PIC) no SUS, e identificar as dificuldades e desafios que se apresentaram em sua implementação, utilização e divulgação nos Serviços de Saúde. Decidiu-se realizar uma pesquisa na zona norte de São Paulo/SP, em uma Unidade Básica de Saúde e em um Ambulatório de Especialidades. A metodologia utilizada foi a qualitativa e os instrumentos, a análise documental e a entrevista, com roteiro pré-estabelecido. Os resultados mostraram que os gestores não estavam preparados para a implementação da Política Nacional de Práticas Integrativas e Complementares (PNPIC) no SUS, que apenas cinco dos vinte e seis entrevistados conheciam a Política Nacional (PNPIC), que ainda prevalece o modelo biomédico nos atendimentos, que o fornecimento de material e aquisição de insumos utilizados em algumas das PIC tem se constituído em grande problema na unidade, que a divulgação das PIC não tem sido suficiente para que profissionais e usuários as conheçam. Nem todos os profissionais que atuavam no Ambulatório de Especialidades onde as PIC têm sido oferecidas têm valorizado essas atividades. As Práticas Integrativas e Complementares não têm ocupado o papel que deveriam e/ou poderiam dentro do SUS para a Promoção da Saúde. Verificou-se que é essencial que o Município de São Paulo/SP incentive e crie condições para o oferecimento das PIC em todas as suas Unidades, aprimorando sua divulgação e apoiando a inserção de profissionais não médicos, desde que apresentem formação adequada, pois práticas como Homeopatia, Acupuntura, Antroposofia e Fitoterapia já são consideradas especialidades médicas. As Práticas Integrativas e Complementares, se integradas ao SUS, certamente poderão contribuir, e muito, para a Promoção da Saúde / Health promotion has been contributing to foster actions which aim at responding to the interests and demands of the population in order to improve the level of their health. As a means of integrating other medical and health care practises, the Ministry of Health adopted, in 2006, the National Policy on Integrative and Complementary Practices (PNPIC) so as to particularly face the need to incorporate and to implement experiences which for some time have been successfully developed in the National Health System (SUS) in response to the desire of the users as expressed on the recommendations of the National Health Conferences, since 1988. That is why it has become more and more urgent to investigate the knowledge, opinions and social representations of managers and health professionals about those practices (PIC) in SUS as well as to identify the difficulties and challenges that are present in their implementation, use and disclosure in the Health Services. In order to better comprehend those issues, a survey in a Basic Health Unit and Specialty Clinic in the northern area of Sao Paulo/SP has been carried out. The chosen methodology was the qualitative approach with its instruments, documentary analysis and interviews based upon pre-established guidelines. The results support the thesis that managers are not prepared to implement the National Policy on Integrative and Complementary Practices (PNPIC) in SUS: only five out of the twenty six respondents were aware of the National Policy (PNPIC); the biomedical model sessions still prevails; material supply and acquisition of raw materials used in some of the PIC has become a major issue in the unit; that the disclosure of the PIC has not been enough so as to be fully known by professional and users alike. Furthermore, most of the professionals working in the Specialty Clinic where the PIC have been offered have undervalued those activities. The Complementary and Integrative Practices have not played the role they should and/or could in the SUS for the Promotion of Health yet. It is pivotally necessary that the City of São Paulo/SP encourages and creates conditions for taking the PIC into all the Health Units, so as to improve, disclosure and support the inclusion of non-medical professionals, provided that they have proper training since practices such as Homeopathy, Acupuncture, Anthroposophy and Phytotherapy are already considered as medical specialties. If they come to be included in SUS, the Complementary and Integrative Practices can certainly contribute a lot for the Promotion of Health

In our studies we found that stabilized expression of HIF-1α in heart led to better recovery of function and less tissue death after 30 minutes of global ischemia, via mechanisms that preserve the mitochondrial polarization. Our group previously showed that HIF-1α conferred ischemic tolerance by allowing cardiomyocytes to use fumarate as an alternative terminal electron acceptor to sustain anaerobic mitochondrial polarization. The source of fumarate was identified as the purine nucleotide cycle (PNC). Here we discovered that HIF-1α upregulates AMP deaminase 2 (AMPD2), the entry point to the PNC. The combination of glycolysis and the PNC may protect the heart's nucleotide resources. We subsequently examined the effects that HIF-1α exerts on nucleotide metabolism in the ischemic heart. We found that HIF-1α expression reduces adenosine accumulation in the ischemic heart. As ATP is depleted during ischemia, AMP accumulates. Our results suggest that AMP metabolism is shunted towards AMPD2 rather than the adenosine producing 5'-nucleotidase pathway. Subsequently, we treated hearts with the PNC inhibitor hadacidin followed by 30 minutes of global ischemia. Inclusion of hadacidin reduced ATP and adenylate energy charge in the hearts. These findings allow us to propose that activity of the PNC prevents the F0F1 ATP synthase from consuming glycolytic ATP in order to maintain mitochondrial polarization during ischemia. Thus, the PNC provides ATP sparing effects and preserves the energy charge in the ischemic heart. The fact that ATP and adenylate energy charge is better preserved during the initial 20 minutes of ischemia in HIF-1α expressing hearts is supportive of our observation that HIF-1α upregulates the PNC. HIF-1α also upregulates adenosine deaminase, which degrades adenosine. The limitation of adenosine accumulation may help HIF-1α expressing hearts avoid toxicity due to chronic adenosine exposure. Finally, we found that HIF-1α induces the expression of the nucleotide salvage enzyme hypoxanthine phosphoribosyl transferase (HPRT). Upon reperfusion HPRT serves to reincorporate the nucleotide degradation product, hypoxanthine, into the adenylate pool and may prevent the production of reactive oxygen species. Collectively, HIF-1α robustly protects the heart from ischemic stress and it upregulates several pathways whose cardioprotective role may extend beyond the remodeling of nucleotide metabolism.

Plants are in a perpetual evolutionary arms race with a wide range of pathogens. Their sessile nature has led plants to evolve defense mechanisms that can quickly recognize a unique stressor and deploy a resistance tailored for a specific attack. The salicylic acid (SA) mediated defense pathway has been shown to be one of the major defense tactics plants can initiate to defend themselves against microbial pathogens. Following a pathogen attack high levels of methyl salicylate (MeSA) are produced that can be converted to SA by the enzyme salicylic acid binding protein 2 (SABP2). A yeast two-hybrid screening was performed to identify protein interactions with SABP2 to better understand the regulation of the enzyme on a cellular level. SBIP-436 is an interacting protein of tobacco SABP2 which showed high homology to phospholipase D-δ (PLD- δ). With an abundance of stimulators PLD- δ may be a lipid signaling modulator developed to perform various functions in different situations. PLD- δ may be a key player in a lipid signaling cascade in the SA mediated defense pathway. We present a novel Nicotiana tabacum PLD- δ putative gene construct. We demonstrate that the putative PLD- δ is subject to alternative splicing and its expression is differentially modulated under biotic and abiotic stress. Our results indicate that this putative PLD- δ may play a role in the SA mediated defense pathway.

Purpose: Accelerometry is commonly used to objectively measure physical activity (PA), however, differential data collection methods and analysis techniques yield dissimilar outcomes. The aims of this research were to (1) understand how accelerometer output varies among accelerometers worn on the non-dominant wrist (NDW), dominant wrist (DW), and hip; (2) develop site-specific algorithms to predict activity type classification, activity intensity classification, and estimates of metabolic intensity; and (3) compare the algorithms in a free-living setting. Methods: Forty participants (16.8 – 64.2 yr) completed a sequence of sedentary and physical activities in a laboratory while wearing accelerometers on the NDW, DW, and hip. Participants also wore a portable metabolic analyzer to objectively measure oxygen consumption (VO2). One-second accelerometer output was compared across wear locations by activity type and intensity classifications (Aim 1). Accelerometer output data were transformed into variables related to the magnitude (ϒ), horizontal angle (φ), and inclination (θ) of acceleration, and used to develop algorithms for the NDW, DW, and hip. Random forest algorithms were developed to predict activity type classification (i.e., sedentary, lifestyle, and ambulatory) and activity intensity classification (i.e., sedentary, light, moderate, and vigorous), and regression models were built to predict VO2 (Aim 2). Following the laboratory visit, participants simultaneously wore an accelerometer at each of the three locations for three days of free-living data collection. The site-specific algorithms developed in Aim 2 were compared for equivalence (Aim 3). Aim 1 Results: Analysis of variance indicated that accelerometer output differed between the NDW, DW, and hip for all activities completed, except for lying supine. Differences were expected; thus, Pearson correlation coefficients were calculated between the NDW, DW, and hip, and compared across activity type and intensity classifications. For activity type, the relationships between all wear locations were different for all activity types (i.e., sedentary, lifestyle PA, and ambulatory PA). For activity intensity, the relationships between the wrists were significantly different between sedentary and light activities. Additionally, relationships between the NDW, DW, and hip differed between light and moderate, and light and vigorous PA for all wear locations. The disparate correlations indicated that accelerometer signals do not just increase in magnitude as intensity increases; rather they increase differentially by wear location and activity type. Aim 2 Results: Site-specific random forest algorithms were developed to predict activity type and intensity classification. The algorithms utilized 10-15 features of the accelerometer signal related to variability, location, and central tendency. The hip had prediction accuracies of 84.9% for activity type classification and 80.2% for activity intensity classification. The dominant wrist had activity type prediction accuracy of 83.6% and intensity prediction accuracy of 78.9%. The non-dominant wrist had prediction accuracies of 83.1% and 78.0% for activity type and intensity, respectively. The VO2 prediction algorithms had Mean Absolute Errors of 2.96 ml/kg/min for the hip, 3.34 ml/kg/min for the NDW, and 3.49 ml/kg/min for the DW. This equates to an average error of 0.93 metabolic equivalents (METs); algorithms currently used in practice yield errors of 0.89 to 2.00 METs. Aim 3 Results: The site-specific prediction algorithms were applied to free-living data. Using the random forest algorithms, activity type classification estimates differed by 2 to 82 minutes/day, and activity intensity classification estimates differed by 0 to 83 minutes/day; however, these differences were not significantly different. The VO2 prediction models provided estimates of PA within 0 to 57 minutes/day of one another. The hip provided the lowest estimates of MVPA, while the NDW provided the highest estimates, however the VO2 estimates from all wear locations were statistically equivalent to one another. Conclusion: The differential relationships among accelerometer outputs from the NDW, DW, and hip indicate that output differs based on activity type and intensity. This non-systematic error prevents scaling or comparing data collected at different wear locations and supports the need for site-specific analysis methods. Site-specific prediction algorithms provided comparable to improved performance over currently-utilized analysis methods in PA research, and the PA estimates were equivalent across wear locations. This research provides a more nuanced understanding of the impact of wear location on accelerometer output and alternative methods for analysis. Importantly, the algorithms created allow for comparisons to be made among data collected at the NDW, DW, and hip, which has not previously been possible.

Background: Women are more likely to develop age-related cognitive impairment compared with men of the same age. Pregnancy complications, such as preeclampsia (PE), and menopause may contribute to an elevated risk of cognitive decline with aging in women potentially through an adverse impact on vascular function. PE is associated with a heightened risk of hypertension and large elastic artery stiffness (i.e., aortic and carotid arteries) for several years postpartum. Persistent large artery stiffness may be further amplified in women with a history of PE during the menopause transition, which is marked by an accelerated rate of vascular aging. However, large artery stiffness has not been studied extensively in postmenopausal women with a history of PE. Age-related elevations in large artery stiffness are associated with cognitive decline in middle-aged and older adults however, this relation has not been investigated in young women with a history of PE. Moreover, the degree to which elevated large artery stiffness is amplified and associated with reduced cognitive function among postmenopausal women with a history of PE remains unknown. The purpose of this study was to examine the extent to which large elastic artery stiffness is associated with reductions in cognitive function in premenopausal and postmenopausal women with a history of PE. Methods: Large elastic artery stiffness and domains of cognitive function were assessed in young women one year postpartum (n=18, ages 24-41 yrs.) and postmenopausal women (n=19, ages 52-77 yrs.) thirty-five years postpartum. Aortic stiffness was measured via non-invasive applanation tonometry at the carotid and femoral pulse sites and expressed as carotid-femoral pulse wave velocity (cfPWV). Carotid artery stiffness was quantified as beta-stiffness index (β-stiffness) was measured via ultrasonography and carotid tonometry. Cognitive tests were administered to assess cognitive function in immediate and delayed recall, working memory, processing speed, and executive function. Results: Premenopausal women with a history of PE had higher systolic blood pressure (121 ± 4 vs. 101 ± 3 mmHg, p =0.01) one year postpartum but did not differ significantly from controls in cfPWV (6.2 ± 0.4 vs. 5.1 ± 0.2 m/s, p =0.08), β-stiffness (6.1 ± 0.5 vs. 6.1 ± 0.7 U, p =0.97), or cognitive domains of memory, executive function, or processing speed (all p>0.05). Higher systolic blood pressure was associated with lower executive function (r = -0.53, p = 0.05) in young women one year postpartum. Postmenopausal women with a history of PE did not differ from controls in blood pressure, large artery stiffness, or age-adjusted cognitive domains of memory, executive function, or processing speed (all p>0.05). Large artery stiffness was not associated with cognitive function in premenopausal or postmenopausal women. Conclusions: Young women with a history of PE had elevated systolic pressure one year postpartum, which was associated with reductions in executive function. Large artery stiffness was not elevated or related to cognitive function in postmenopausal women with a history of PE. These preliminary findings suggest that young women with a history of PE are susceptible to reductions in selective cognitive domains related to higher blood pressure, but this effect does not appear to extend into the postmenopausal period.

Physical activity (PA) provides many benefits to adolescents with Type 1 Diabetes (T1D); however, adolescents with T1D tend to have lower fitness and PA levels. One reason adolescents with T1D engage in less PA is due to a fear of hypoglycemia. Most studies examining PA in relation to glycemic control measure PA through self-report, thus introducing bias. The purpose of this study was to objectively monitor PA and glucose in adolescents with T1D to examine the temporal associations between moderate and vigorous intensity physical activity (MVPA) and hypoglycemia. Twenty participants (14 to 19 yr, n=10 females and 10 males) with a T1D diagnosis for at least 1 year were recruited. Participant fitness was evaluated via indirect calorimetry during a maximal treadmill exercise test, and body composition was measured using air displacement plethysmography. An accelerometer (GENEActiv, Activinsights Ltd, Kimbolton, UK) was worn on the wrist continuously for 7 days and the waveform data used to estimate MVPA in min/d. Blood glucose values were simultaneously tracked using continuous glucose monitoring (DexCom SEVEN PLUS, San Diego, CA). After controlling for gender, % body fat (%BF), and fitness, the likelihood of hypoglycemia (¡Ü 70 mg/dl) at nighttime or the next day due to MVPA was examined using logistic regression. Participants were of avg fitness (females: 43.9 ml/kg/min; males: 49.8 ml/kg/min) and fatness (females: 26.2%; males: 19.2%), and 63.2% of participants met the US federal guidelines of accumulating 60 min/d of MVPA. Hypoglycemia was 22% more likely in those who had 30 min/d more MVPA than those with less (95% CI: 1.03, 1.45; p =0.022). The results indicate that participating in MVPA increases the risk of hypoglycemia during the night time and the following day. The relationship is independent of gender, %BF and fitness. While promoting PA as a healthy behavior, it is important to educate adolescents with T1D on prevention of hypoglycemia following PA.